利伐沙班治疗老年非瓣膜性心房颤动患者的有效性及安全性分析
【摘要】 目的 探讨老年非瓣膜性心房颤动患者采用利伐沙班治疗的有效性及安全性。方法 60例老年非瓣膜性心房颤动患者， 依据抗凝治疗方法不同分为利伐沙班组和华法林组， 各30例。利伐沙班组患者接受利伐沙班抗凝治疗， 华法林组患者接受华法林抗凝治疗。比较两组患者的栓塞事件、出血事件、不良反应发生情况。结果 利伐沙班组患者的栓塞事件发生率为10.0%(3/30)， 华法林组患者的栓塞事件发生率为13.3%(4/30)， 两组比较差异无统计学意义(P>0.05)。利伐沙班组患者的出血事件发生率为3.3%， 低于华法林组的20.0%， 差异具有统计学意义(P<0.05)。利伐沙班组患者的不良反应发生率为16.7%， 低于华法林组的40.0%， 差异具有统计学意义(P<0.05)。结论 老年非瓣膜性心房颤动患者采用利伐沙班抗凝治疗的有效性及安全性较华法林高， 更能有效降低患者的出血事件、不良反应发生率， 值得推广。
【关键词】 利伐沙班;抗凝治疗;老年非瓣膜性心房颤动;有效性;安全性
DOI：10.14163/j.cnki.11-5547/r.2020.03.002
【Abstract】 Objective To discuss the efficacy and safety of rivaroxaban in the treatment of elderly patients with nonvalvular atrial fibrillation. Methods A total of 60 elderly patients with nonvalvular atrial fibrillation were divided into rivaroxaban group and warfarin group by different anticoagulant methods， with 30 cases in each group. Rivaroxaban group received rivaroxaban for anticoagulant treatment， and warfarin group received warfarin for anticoagulant treatment. The occurrence of embolism events， bleeding events and adverse reactions were compared between the two groups. Results The incidence of embolism events was 10.0%(3/30) in rivaroxaban group， which was 10.0%(3/30) in warfarin group， and the difference was not statistically significant (P>0.05). The incidence of bleeding events was 3.3%， which was lower than 20.0% in warfarin group， and the difference was statistically significant (P<0.05). The incidence of adverse reactions was 16.7% in rivaroxaban group， which was lower than 40.0% in warfarin group， and the difference was statistically significant (P<0.05). Conclusion The efficacy and safety of rivaroxaban anticoagulation in elderly patients with nonvalvular atrial fibrillation is higher than warfarin， and it can effectively reduce the incidence of bleeding events and adverse reactions. It is worth popularizing.
【Key words】 Rivaroxaban; Anticoagulation therapy; Elderly nonvalvular atrial fibrillation; Efficacy; Safety
心房顫动的发病率随着年龄的增长而提升， 60岁及以上的老年人群达到了3%～4%的发病率， 80岁及以上的高龄人群达到了9%的发病率， 和女性相比， 男性具有显著较高的发病率， 极易造成老年人死亡[1]。因此， 临床很有必要积极采取有效措施治疗老年非瓣膜性心房颤动， 从而将患者的死亡率降低到最低限度。为了将有效依据提供给临床对老年非瓣膜性心房颤动患者的治疗工作， 从而使患者生命安全得到切实有效的保证， 有效延长患者生存期， 改善患者生存质量， 本研究比较了老年非瓣膜性心房颤动患者采用利伐沙班与华法林抗凝治疗的有效性及安全性， 现报告如下。
1 资料与方法
1. 1 一般资料 随机选取2015年5月～2017年5月本院心内科收治的老年非瓣膜性心房颤动患者60例， 依据抗凝治疗方法不同将患者分为利伐沙班组和华法林组， 各30例。利伐沙班组患者中男19例， 女11例;年龄60～71岁， 平均年龄(65.4±10.6)岁;心房颤动类型：11例为永久性， 9例为持续性， 10例为阵发性。华法林组患者中男17例， 女13例;年龄61～71岁， 平均年龄(66.2±10.3)岁;心房颤动类型：12例为永久性， 10例为持续性， 8例为阵发性。两组患者一般资料比较， 差异无统计学意义(P>0.05)， 具有可比性。见表1。, http://www.100md.com(仝瑞龙)
【关键词】 利伐沙班;抗凝治疗;老年非瓣膜性心房颤动;有效性;安全性
DOI：10.14163/j.cnki.11-5547/r.2020.03.002
【Abstract】 Objective To discuss the efficacy and safety of rivaroxaban in the treatment of elderly patients with nonvalvular atrial fibrillation. Methods A total of 60 elderly patients with nonvalvular atrial fibrillation were divided into rivaroxaban group and warfarin group by different anticoagulant methods， with 30 cases in each group. Rivaroxaban group received rivaroxaban for anticoagulant treatment， and warfarin group received warfarin for anticoagulant treatment. The occurrence of embolism events， bleeding events and adverse reactions were compared between the two groups. Results The incidence of embolism events was 10.0%(3/30) in rivaroxaban group， which was 10.0%(3/30) in warfarin group， and the difference was not statistically significant (P>0.05). The incidence of bleeding events was 3.3%， which was lower than 20.0% in warfarin group， and the difference was statistically significant (P<0.05). The incidence of adverse reactions was 16.7% in rivaroxaban group， which was lower than 40.0% in warfarin group， and the difference was statistically significant (P<0.05). Conclusion The efficacy and safety of rivaroxaban anticoagulation in elderly patients with nonvalvular atrial fibrillation is higher than warfarin， and it can effectively reduce the incidence of bleeding events and adverse reactions. It is worth popularizing.
【Key words】 Rivaroxaban; Anticoagulation therapy; Elderly nonvalvular atrial fibrillation; Efficacy; Safety
心房顫动的发病率随着年龄的增长而提升， 60岁及以上的老年人群达到了3%～4%的发病率， 80岁及以上的高龄人群达到了9%的发病率， 和女性相比， 男性具有显著较高的发病率， 极易造成老年人死亡[1]。因此， 临床很有必要积极采取有效措施治疗老年非瓣膜性心房颤动， 从而将患者的死亡率降低到最低限度。为了将有效依据提供给临床对老年非瓣膜性心房颤动患者的治疗工作， 从而使患者生命安全得到切实有效的保证， 有效延长患者生存期， 改善患者生存质量， 本研究比较了老年非瓣膜性心房颤动患者采用利伐沙班与华法林抗凝治疗的有效性及安全性， 现报告如下。
1 资料与方法
1. 1 一般资料 随机选取2015年5月～2017年5月本院心内科收治的老年非瓣膜性心房颤动患者60例， 依据抗凝治疗方法不同将患者分为利伐沙班组和华法林组， 各30例。利伐沙班组患者中男19例， 女11例;年龄60～71岁， 平均年龄(65.4±10.6)岁;心房颤动类型：11例为永久性， 9例为持续性， 10例为阵发性。华法林组患者中男17例， 女13例;年龄61～71岁， 平均年龄(66.2±10.3)岁;心房颤动类型：12例为永久性， 10例为持续性， 8例为阵发性。两组患者一般资料比较， 差异无统计学意义(P>0.05)， 具有可比性。见表1。, http://www.100md.com(仝瑞龙)